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Current Hepatology Reports
Erschienen in: Current Hepatology Reports 3/2019

22.07.2019 | Hepatitis B (JK Lim, Section Editor)

Management of Virologic Failure in Patients with Chronic Hepatitis B Treated with Nucleos(t)ide Analogues

verfasst von: Zaid H. Tafesh, Robert S. Brown Jr

Erschienen in: Current Hepatology Reports | Ausgabe 3/2019

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Abstract

Purpose of the Review

Poorly controlled hepatitis B increases the risk for liver-related morbidity. Although there are now six approved nucleos(t)ide analogues (NA) for the treatment of chronic hepatitis B (CHB), drug resistance and thus virologic breakthrough still exist. This review outlines a systematic approach to the management of virologic failure in patients with CHB treated with NAs.

Recent Findings

Current NAs can be divided into older generation and newer generation agents, with newer generation agents associated with lower rates of virologic breakthrough. Both tenofovir dipovoxil fumarate (TDF) and tenofovir alafenamide (TAF) are equally as effective in addressing virologic breakthrough while on all other NAs. Entecavir is an effective treatment option for NA naïve patients only, with high rates of resistance to entecavir in those exposed to older NAs.

Summary

The management of virologic breakthroughs should focus on identifying risk factors for future drug resistance and escalation to appropriate newer generation drug options to avoid long-term liver-related morbidity.
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Metadaten
Titel
Management of Virologic Failure in Patients with Chronic Hepatitis B Treated with Nucleos(t)ide Analogues
verfasst von
Zaid H. Tafesh
Robert S. Brown Jr
Publikationsdatum
22.07.2019
Verlag
Springer US
Erschienen in
Current Hepatology Reports / Ausgabe 3/2019
Elektronische ISSN: 2195-9595
DOI
https://doi.org/10.1007/s11901-019-00483-z

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